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Transpedicular Approach Surgery

The vertebral column is made up of individual bones (vertebrae) stacked one above the other. These are protected by spongy intervertebral discs that cushion the spine during movements such as lifting, running, and jumping. Degeneration, diseases, and trauma to these discs can cause them to herniate (bulge) beyond the level of the vertebrae, compressing the adjacent spinal cord and causing pain, numbness, weakness, and changes in bladder and bowel functions. The transpedicular approach is a surgical procedure to treat thoracic disc herniation.

To perform the transpedicular approach surgery, you will lie in a prone position (on your stomach) and your surgeon will make a midline incision along with the herniated disc. The exact position of the herniation is estimated through fluoroscopy. The overlying muscles are separated to expose the surgical site. Your surgeon then identifies the thoracic pedicles, the stubs of bone that extend on either side of the main vertebral body, which house the discs, to join and form an arch around the spinal cord. This pedicle is removed using a high-speed drill to expose the herniation. The fragments of the herniated disc causing the compression are removed. The muscles are then released and the incision closed.

Transpedicular approach surgery, when compared to other surgical options for treating disc herniation, is associated with fewer comorbidities. However, as with all surgeries, it may be associated with certain complications such as infection, an abnormal accumulation of cerebrospinal fluid outside the spinal cord, and worsening of symptoms.